Healthcare Provider Details

I. General information

NPI: 1841397981
Provider Name (Legal Business Name): ALAN D GAINES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 VETERANS MEMORIAL PKWY BLDG 15A
EAST PROVIDENCE RI
02914-5300
US

IV. Provider business mailing address

450 VETERANS MEMORIAL PKWY BLDG 15A
EAST PROVIDENCE RI
02914-5300
US

V. Phone/Fax

Practice location:
  • Phone: 401-331-8426
  • Fax: 401-331-5138
Mailing address:
  • Phone: 401-331-8426
  • Fax: 401-331-5138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD07370
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: